家族内, 家族外結核感染における感染源と二次患者の男女比 GENDER DIFFERENCE IN INDEX AND SECONDARY PATIENTS WITH OR WITHOUT HOUSEHOLD CONTACT

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〔目的〕結核感染における男女比の実態を知る。〔対象と方法〕1989年から2003年までの15年間に,愛知県の3保健所1支所で薪登録された3,174名の肺結核患者登録票を再点検し,感染経路を同じくする複数の発病者からなるクラスターを選別した。クラスター内の最初の登録者を初発患者とし,それ以後の登録者を二次患者とし,初発患者と二次患者の登録期間を10年以内とした。塗抹陽性初発患者を感染源とし,その二次患者を家族内と家族外に分け,男女比を求めた。〔結果〕感染源は100名で,男女比3.3,その二次患者は153名,男女比1.0であった(p<0.001)。家族内感染の男女比は家族外感染と比べ,感染源でも(2.5vs21.0,p<0,05),二次患者でも(0.8vs2.2,p<0.011)低かった。家族内感染の二次患者の男女比は,夫婦間発病でO.4,夫婦以外で1.0であった(p<0.05)。家族外感染で,職場感染の二次患者の男女比は7.0,職場以外では0.8であった(p<0.01)。〔考察〕感染源は男性が多く,夫婦間発病の二次患者は必然的に女性が多い。ある地域における家族内男女数はほぼ同数であり,男女各1名からなる夫婦を除く家族内男女数もほぼ同数であり,二次患者が男女ほぼ同数ということは,家族内感染での発病率に男女差がないことを示唆する。〔結論〕家族内感染は家族外感染より男女比が低い。

[Objectives] To investigate gender difference in index and secondary patients with or without household contact.<BR>[Subjects and Methods] The subjects of this retrospective study were 3, 174 pulmonary TB patients registered in Aichi prefecture between 1989 and 2003. All recorded files were reviewed to identify epidemiologically-related TB patient clusters. In case of epidemiologically-related patients registered within less than 10 years interval, the first registered patients was defined as the index case of the cluster. The other patients in the cluster were defined as secondary cases. Therefore, all pulmonary TB patients were classified to index, secondary, or unclustered cases. An index patient with sputum smear positive was defined as the source of transmission in the cluster. The male/female ratio was calculated separately in the sources and secondary patients with or without household contact.<BR>[Results] A total of 100 source patients were identified. Of these, 77 were male and 23 were female, and the male/female ratio was 3. 3. The secondary patients were 153, of whom 77 were male and 76 were female, and the male/female ratio was 1. 0. The difference of the male/female ratio was statistically significant (p < 0. 001).<BR>The male/fem ale ratio in the source patients was 2. 5 for 78 clusters with household contact and 21. 0 for 22 clusters without household (p< 0. 05), while the ratio in the secondary patients were 0. 8 and 2. 2 respectively (p< 0. 01). Of the 111 secondary patients with household contact, the relations to the source patients were wife-husband in 32, parent-child in 55, brother or sister in 12, grandparent-grandchild in 8, and the others in 4. In the 32 wife-husband transmission, most secondary patients were female (male/female = 9/23) while in other 67 transmissions with household contact, male and female secondary cases were almost same (male/female= 39/40). The male/female ratios in these two settings were significantly different (0. 4 vs 1. 0, p< 0. 05). Of the 42 secondary patients without household contact, transmission were occurred in working places in 24, schools in 11, religion circles in 4, hospital in one, and others in 2. The male/female ratio of secondary cases was 7. 0 for transmission at working places, and 0. 8 for transmission at the other places (p< 0. 01).<BR>[Conclusion] These findings suggest that the male/female ratio of secondary patients with household contact is significantly lower than that of those without household contact.

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  • 結核  

    結核 81(11), 645-650, 2006-11-15 

    JAPANESE SOCIETY FOR TUBERCULOSIS

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各種コード

  • NII論文ID(NAID)
    10018570669
  • NII書誌ID(NCID)
    AN00073442
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00229776
  • NDL 記事登録ID
    8577081
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z19-133
  • データ提供元
    CJP書誌  CJP引用  NDL  J-STAGE 
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